Testicular Cancer

Overview

Testicular cancer is a relatively rare form of cancer which accounts for approximately one percent of all male tumors, with more than 5,000 new cases detected annually. Treatment for testicular cancer includes radiation therapy, chemotherapy and surveillance depending on the diagnosis and staging. Testicular tumors occur mainly between the ages of 20 and 40 years, but there are specific tumors of childhood and elderly men as well. However, the majority of testicular and scrotal lesions identified by patients are benign in nature.

The testicles are responsible for producing sperm and the male hormone testosterone. There are certain risk factors for the development of testicular cancer. Caucasian men have a higher incidence than other ethnic groups. Men with a history of an undescended testicle (usually located in the groin or abdomen) which is not brought back into the scrotum in childhood are at increased risk of cancer and need to be followed carefully even after the testicle is placed into the scrotum.

Evaluation

The most common physical finding is a hard lump in the testicle. It is very important for men to examine both of their testicles on a monthly basis in order to detect tumors early. There is usually no pain in the testicle although at times the breasts may be tender due to production of substances by the tumor that cause tender enlargement of the breast tissue. Men are often embarrassed at the prospect of having a doctor examine their genitals, but early detection is very important in successful treatment.

The doctor will examine the testicles carefully and decide if there is a problem within the testicle, or possibly a structure close to the testicle. An ultrasound may be performed to help determine the relevant anatomy of the testicle and lesion.

Treatment

Radiation therapy, chemotherapy and surveillance are the best treatment options for testicular cancer, depending on the data accumulated. If a testicle tumor is identified, then the testicle will need to be removed surgically. Preoperative chest X-rays and blood tests will be performed. The most important determinant of future treatment is dependent on the exact pathologic diagnosis and staging by X-rays. Some patients will need to undergo a surgical removal of the abdominal lymph nodes to rule out involvement of these areas.

Testicular cancer treatment options include:

Radiation Therapy

Radiation therapy uses high energy particles or waves to treat cancer cells. Only cancer cells in the area where the radiation is delivered are killed. Our radiation oncology team includes radiation oncologist, physicists and dosimetrists skilled in treating testicular cancer using radiation therapy.

Chemotherapy

Chemotherapy involves taking cancer-fighting drugs either orally, as injections, or as IV infusion. The medication circulates in the bloodstream, killing testicular cancer cells. Physicians administer chemotherapy in scheduled sessions, each with built-in periods of recovery time for the body.

Surveillance

You and your physician will decide on the appropriate treatment for testicular cancer based on the stage of the cancer and other factors. In some cases, surveillance, sometimes called “observation” or “watchful waiting,” is recommended if immediate treatment is not needed.

Sometimes the side effects of treatment can outweigh the benefits of treatment. You will be closely monitored, and if circumstances change, your physician will discuss active treatment options with you.

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